KURUKSHETRA UNIVERSITY KURUKSHETRA

11. Academic Record:ExamUniversity/Board/InstituteYear ofPassingRoll No. Subjects MarksobtainedMax.Marks% age ofMarksInstructions:1. All the candidates have to bring all original documents alongwith fees and one set of attestedphotocopies of the same and required fee at the time of counseling.2. Attach Photocopy of Certificate of D.Pharmacy/10+2 DMC/Haryana Domicile, whichever isapplicable.Declaration by the applicant:I declare that entries made by me in this Application Form are true in all respects and in any case, anyentry or information is found to be false, this shall entail automatic cancellation of my admissionbesides rendering me liable to such action as the university may deem proper.I note that my admission to the university and my continuance on its rolls are subject to the provisionof the university and any other rules and instructions, which may be issued from time to time. I shallabide by the rules of discipline and proper conduct, which may be framed in this regard. I am fullyaware of the law regarding ragging as well as the punishment and that if found guilty on this account,I am liable to be punished appropriately.I undertake that I shall not indulge in any act of ragging.Signature of the Father/Mother/GuardianSignature of the ApplicantDate __________________Place __________________For office useAdmittedDirector,Institute of Pharmaceutical Sciences